RNIB Scotland's Education and Family Services (EFS) Team Invite You to a Summer Extravaganza

RNIB Scotland's Education and Family Services (EFS) Team invite you to a summer extravaganza Shape and Share Event in Falkirk.

Saturday 25 June 2016, 1100 -1500, Camelon, followed by Falkirk Wheel.

Registration Form

Section 1

I am Parent / Guardian / Young Person 18 or over / Young Person under 18 (Please delete/circle as appropriate)

If you are a parent or guardian bringing children/ young people please list theirdetailsin section 2

Name:

Date of birth if under 18:

Correspondence address:

Telephone:

Mobile:

Email:

Any Dietary Requirements:

Details of Visual Impairment:

Other additional support needs (if any):

Section 2

Name:

Date of birth:

Any dietary requirements:

Details of Visual Impairment:

Other additional support needs (if any):

Name:

Date of birth:

Any dietary requirements:

Details of Visual Impairment:

Other additional support needs (if any):

Please continue on a separate page if necessary.

Do you require transport between Forth Valley sensory centre and the Falkirk Wheel?

Signature Parent / Guardian (if child/children under 18):

Date:

Please turn over page for section 3 and section 4

Section 3

Fair Processing Notice

Action for Blind People (Action) is part of the RNIB group of charities. In order to provide you with the best and most efficient service, RNIB needs to use some personal information about you, so that we can deliver services to you.

We do not trade or share customer data outside RNIB Group and Action unless required by a legal duty. If we need to refer you to another organisation, as part of the service you are receiving from us, we will confirm with you each time that you are happy for us to release your information.

The RNIB Group Data Protection Policy is available on request.

Signature Parent / Guardian (if child/children under 18):

Date:

Section 4

Photography Consent form

I give permission to RNIB to use any film footage, audio interviews and photographs of the person / people named on this form.

For use in the following:

All RNIB publications (including magazines, annual reviews, campaign reports, fundraising materials, audio-visual, website and exhibition materials)

Any external publishing (including media and PR work)

For a period of: up to five years

Signature Parent / Guardian (if child/children under 18):

Date:

Please complete and return the registration form to EFS, RNIB Scotland, 12-14 Hillside Crescent, Edinburgh EH7 5EA or e-mail by Monday 6 June 2016.